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Overhaul Of Health Support For Under-fives – Expert Reaction

The government has signalled a major makeover to a screening and support programme for the earliest years of a child’s life.

The Well Child Tamariki Ora health programme provides wellness checkups for families with children from birth to 5 years old, aiming to boost health and development. But a government review has found the initiative is outdated, and fails to meet the needs of children who are Māori, Pacific, living with disabilities, in state care, and those with high needs.

The SMC asked experts to comment on the announcement.

Dr Jin Russell, Developmental Paediatrician, Starship Children’s Hospital and PhD Student, School of Population Health, University of Auckland, comments:

“As a developmental paediatrician and child health researcher, I welcome the government’s announcement to reform the Well Child Tamariki Ora system.

“While many children in Aotearoa NZ are doing well, large numbers of children are being left behind by the current system. In the first 1000 days, that is, by age 2, large inequities can be seen in children’s health and development, and these gaps are sustained right through until school entry. Poverty, disadvantage, poor housing, family stress, and the impacts of colonisation all negatively affect health and development, over the life course. I see the impacts of this upon children in my paediatric clinic every week as well as in my research.

“We need to aim to be a society where every child is enabled to reach their full developmental potential. Children are our future citizenry, and they are precious.

“In the 1940s, New Zealand was credited with having the lowest infant mortality rate in the world. But in UNICEF’s 2020 report card, NZ was ranked at almost the bottom of the OECD in child health, developmental and wellbeing outcomes.

“Early investment in children is more impactful and cost-effective than remedial investment at a later age. I welcome the intentions to make the system more equitable, more integrated with other social services, more whanau-centred, and accompanied by joined-up IT.

“I hope that the changes are funded adequately to achieve the vision of the report.”

Conflict of interest statement: Dr Jin Russell is a consultant developmental paediatrician in Tāmaki Makaurau Auckland. Her PhD research with the University of Auckland’s Growing Up in NZ study focuses on inequities in early child health and development.

Annette Henderson, Associate Professor, Rutherford Discovery Fellow & Director of the Early Learning Lab, School of Psychology, University of Auckland, comments:

“The announcement provided by Honourable Dr. Ayesha Verrall on the recently-published review of the Well Child Tamariki Ora (WCTO) programme is a welcomed one.

“The review is clearly comprehensive, including evidence from qualitative and quantitative research on ten key domains, and undoubtedly suggests that substantial changes need to be made to the WCTO programme to ensure that all tamariki across New Zealand are given the best start to life. A best start to life is key since (as noted by Hon Dr Verrall) the first 1000 days of life has significant consequences for the long-term health and well-being of our tamariki.

“While the promise of change to the WCTO is a welcomed one, one important challenge that will need to be carefully considered is to ensure that the tamariki of the present are not left without support while the focus is on developing the new WCTO for the tamariki of our future.”

No conflict of interest.

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